National Provider Identifier Database

WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI LLC
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI, LLC
152 GATEWAY DR
BILOXI, MS39531-4409
Phone: 225-924-1910
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI, LLC

NPI Number 1376157032
Legal business name
LBN
WOODLAKE ADDICTION RECOVERY OF MISSISSIPPI, LLC
Authorized official KENDALL MCCULLAR - (CREDENTIALING SPECIALIST)
Entity Organization
Organization subpart Yes
Enumeration date 09/01/2020
Last updated 09/01/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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